{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:58:35Z","timestamp":1791979115806,"version":"4.4.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":36,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Vancomycin-resistant Enterococcus faecium (VREfm) bloodstream infections (BSIs) pose significant management challenges with uncertainties relating to the optimal daptomycin dose for treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective cohort study of adult patients receiving \u22653\u2005days of definitive treatment for a first episode VREfm BSI between 2015 and 2022 was undertaken. Daptomycin doses were classified as low (\u22647.9\u2005mg\/kg), medium (8.0 to 9.9\u2005mg\/kg) or high (\u226510\u2005mg\/kg). We aimed to assess the association between daptomycin dose and in-hospital 30-day all-cause mortality in addition to other clinical outcomes (hospital length of stay, transfer to the ICU within 48\u2005hours and microbiological failure). In addition, we undertook a comparative analysis of mortality and other outcomes in vanB VREfm BSIs receiving definitive daptomycin and teicoplanin treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 191 patients received definitive daptomycin (n\u200a=\u200a111) or teicoplanin (n\u200a=\u200a80) therapy and were included in two separate analyses. Of the 111 daptomycin patients, most received high-dose daptomycin (59.5%), with 29.7% and 10.8% receiving medium and low doses, respectively. All-cause 30-day in-hospital mortality was 17.1% and there was no association between daptomycin dose groups and in-hospital 30-day mortality (log rank P\u200a=\u200a0.369). Microbiological failure was associated with dose (P\u200a=\u200a0.036): 33.3% in the low dose group, 12.1% for medium and 19.7% for high. No mortality difference was observed between vanB VREfm BSIs treated with daptomycin or teicoplanin [adjusted cause-specific hazard ratio 0.67 (95% CI: 0.28\u20131.59)].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this contemporary study of predominantly high daptomycin doses, there was no association between daptomycin dose and 30-day in-hospital mortality but we did observe an association with microbiological failure.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jacamr\/dlaf172","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T13:35:18Z","timestamp":1760016918000},"source":"Crossref","is-referenced-by-count":2,"title":["Association between daptomycin dosing and in-hospital mortality in patients with vancomycin-resistant <i>Enterococcus faecium<\/i> bloodstream infection"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9969-3972","authenticated-orcid":false,"given":"Kelly A","family":"Cairns","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, The Alfred Hospital and School of Translational Medicine, Monash University , Melbourne ,","place":["Australia"]},{"name":"Pharmacy Department, Alfred Health , Melbourne ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6590-6127","authenticated-orcid":false,"given":"Iain J","family":"Abbott","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Alfred Hospital and School of Translational Medicine, Monash University , Melbourne ,","place":["Australia"]},{"name":"Microbiology Unit, Alfred Health , Melbourne ,","place":["Australia"]},{"name":"Centre to Impact AMR, Monash University , Clayton ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6284-2022","authenticated-orcid":false,"given":"Andrew A","family":"Udy","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University , Melbourne ,","place":["Australia"]},{"name":"Department of Intensive Care and Hyperbaric Medicine, The Alfred , Melbourne ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2370-2438","authenticated-orcid":false,"given":"Trisha N","family":"Peel","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Alfred Hospital and School of Translational Medicine, Monash University , Melbourne ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8409-4248","authenticated-orcid":false,"given":"Sue J","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Alfred Hospital and School of Translational Medicine, Monash University , Melbourne ,","place":["Australia"]},{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford , Oxford ,","place":["UK"]},{"name":"Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University , Bangkok ,","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J","family":"Dooley","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Alfred Health , Melbourne ,","place":["Australia"]},{"name":"Centre for Medicines Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University , Parkville ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2296-2126","authenticated-orcid":false,"given":"Anton Y","family":"Peleg","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Alfred Hospital and School of Translational Medicine, Monash University , Melbourne ,","place":["Australia"]},{"name":"Centre to Impact AMR, Monash University , Clayton ,","place":["Australia"]},{"name":"Infection Program, Monash Biomedicine Discovery Institute, Department of Microbiology, Monash University , Clayton ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,10,9]]},"reference":[{"key":"2025100909351097900_dlaf172-B1","doi-asserted-by":"publisher","first-page":"e0005922","DOI":"10.1128\/cmr.00059-22","article-title":"Therapeutics for vancomycin-resistant enterococcal bloodstream 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